Haitian Child

Saturday, March 22, 2014

Screening Children in Gigante

Screening for common medical problems is a fundamental principle of good care and basic to preventative care. The Canadian and American Paediatric Societies recommend screening of children for a variety of problems.Next week we will initiate screening for some of the common paediatric problems in Gigante children.Our brigade of volunteers will divide into six teams to perform examinations for the following childhood concerns.GrowthNutritionImmunization VisionBlood PressureUrineGrowth will be assessed with height, weight, head circumference (infancy), and body mass index (BMI). The results will be plotted on standard charts provided by the Centre for Disease Control in Atlanta, Georgia. Measurements at future clinic visits will document the trajectory of growth for each child. When a child is not growing, there is a reason, and the cause needs to be determined and a solution found.Nutrition will be assessed with a mini-program I developed based on data in Bowes and Church's book on the nutritional content of common foods. This book is the "bible" for North American nutrition analysis. Brigadistas will ask the mothers questions to determine the content of a typical daily diet (breakfast, lunch, dinner, snacks) and the program will provide data on calories, carbohydrate, protein, fat, sodium, calcium, iron, and the usual vitamins. The data will be compared to the Recommended Dietary Allowance (RDA) for age and gender for children in the United States. Based on this data, nutrition advice can be offered.Nicaragua has a very good immunization program, but no country is perfect. The immunization status of every child will be checked against the schedule recommended by the Ministry of Health and any discrepancies will be followed up by Dr. Mariana, the local physician. Snellen charts will be used to screen vision from 20 feet away. Special childhood charts with common objects will be used for the younger children who do not yet know their letters. Blood pressure problems are not common in childhood, but when present, deserve attention. We will have a full range of blood pressure cuffs to assess children over the age of three years. Urine problems are likely common, especially infection, and urine dipsticks will be used to check a fresh urine specimen in each child. Children with poor growth, high blood pressure, or an abnormal urine test will be assessed by me later in the week at special clinics.At future visits, I hope to bring technology to test hearing and hemoglobin.If you reached the end of this blog and enjoy birds, please check out my Bird of the Day blog for this visit to Nicaragua. http://lanerobsonsblog.blogspot.com/